Response 1
According to the American Psychiatry Association (2013), boundaries between various disorders may shift in the course of life, while attributed symptoms may also appear in other disorders depending on case severity. Bereavement with a span of 1-2 years, has been classified as a psychological stressor, usually proliferating MDD, while grief in a similar episode shifts classification to PDD. This occurs when an individual loses pleasure in activities and engulfed in guilt or feels worthless (Uher et al., 2014). In this situation, Cognitive behavioral therapy and family therapy, can actively help alleviate these symptoms and failed approaches can be approached through antidepressants. PDD's first line approach is psychotherapy since direct incorporation of medications i.e. antidepressants can increase the rate and level of associated symptoms. MDD has been known to disrupt personal ability through emotional and physical interference. On the other hand, PDD's impact is more broad and severe: relationships, social life, family integration problems or conflicts and individual health. Intensity of symptoms help distinguish between MDD and PDD, with the latter developing from untreated MDD causing medical illnesses and decreased performance or quality of life.
Response 2
I concur with your perspective on combined pharmacotherapy and psychotherapy to serve as a treatment evaluation for both patients. Time taken to subside particular elements such as behavioral traits, can be effectively used to categorize MDD and PDD (Otte et al., 2016). PDD recovery process takes longer periods of time to recover with various psychotherapy combinations being recommended. To mend social issues such as interpersonal disputes and emotional conflicts, a professional may recommend combined cognitive, psychodynamic and interpersonal therapies. Introducing Jennifer to antidepressants without behavioral therapy would yield less results or even worsen her case. Due to the acute symptoms onset, and the severity of behavioral patterns, she would require initial introduction to targeted cognitive behavioral therapy to enable her integrate with a suitable medication. Patient history may inclusively help understand associated risk factors and disorder progression which may yield recurrence or severity, therefore helping choose and appropriate management therapy.
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References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th). Arlington, VA: American Psychiatric Publishing.Otte, C., Gold, S. M., Penninx, B. W.,
Pariante, C. M., Etkin, A., Fava, M., ... & Schatzberg, A. F. (2016). Major depressive disorder. Nature Reviews Disease Primers , 2 , 16065.
Uher, R., Payne, J. L., Pavlova, B., & Perlis, R. H. (2014). Major depressive disorder in DSM‐5: Implications for clinical practice and research of changes from DSM‐IV. Depression and anxiety , 31 (6), 459-471.
